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Description Humana Military is the Managed Care Support Contractor (MCSC) for the Department of Defense (DoD) charged with administering the TRICARE health plan in the East Region. While the contract is ..
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Description Humana's National Medicaid Quality team is seeking a Market ... for supporting individual Medicaid market quality teams and serving as the ... the corporate level National Medicaid Quality team..
Description The Senior Quality Improvement Professional will focus organizational ... on improving Kentucky Medicaid clinical quality performance measures to achieve optimal ... to achieve optimal performance and quality for the..
Job ID 21000GL9Available Openings 2Position Specific Information No experience necessary! We offer paid training. 1225 W 86TH ST Indianapolis, IN 46260DescriptionProvide your personal attention and kindness, professional insight, and a generosity ..
... so that our members receive quality healthcare at an affordable price. You ... (RN) license 3 years of healthcare experience within a fraud investigations ... well as solid knowledge..
Description The Medical Director relies on medical background and reviews health claims. The Medical Director work assignments involve moderately complex to complex issues where the analysis of situations or data requires ..
Description The Associate Director, Quality Assurance for Humana/Your Home Advantage ... programs to establish and maintain quality standards of existing products and ... Wellness Assessments. The Associate Director, Quality Assurance..
... policy requirements. Ensure provision of quality patient care while maintaining cost-effective ... for supporting and driving FMS quality standards through meeting all ESRD ... requirements and the practice of..
Job ID 21000HFNAvailable Openings 1Position Specific Information 1594 E MAIN ST Danville, IN 46122 PURPOSE AND SCOPE: The registered professional nurse (CAP RN 1) position is an entry level designation into ..
Description The Senior Medicaid Quality Data and Reporting Analyst generates ... factors. Responsibilities The Senior Medicaid Quality Data and Reporting Analyst will ... the management and manipulation of quality data..
POSITION SUMMARY: Amada Senior Care of Greater Indianapolis is seeking a full-time Care Coordinator who is a team player with high energy and outstanding customer service skills. Our mission is to ..
... the FMCNA commitment to the Quality Enhancement Program (QEP) and CQI ... patients will achieve the FMC Quality Enhancement Goals (QEP). PRINCIPAL DUTIES ... to support the delivery of..
Description The Utilization Management Behavioral Health Professional 2 utilizes behavioral health knowledge and skills to support the coordination, documentation, and communication of medical services and/or benefit administration determinations. The Utilization Management ..
... 41) market leader in integrated healthcare with a clearly defined purpose ... we are seeking an experienced healthcare leader to join our team ... President, Strategy Advancement for our..
... moderate to substantial. Responsibilities The Quality Technology Leader collaborates with business ... to ensure the maturity of quality in the delivery of technology ... experienced with testing principles and..
Description The Vendor Quality Medical Director will manage clinical ... Director will manage clinical vendor quality outcomes for Humana Clinical Operations ... Director to manage clinical vendor quality outcomes for..
... the development and implementation of quality improvement interventions and audits and ... years of experience in Accreditation, Quality Management, Compliance, Utilization Management, Behavioral ... degree Advanced degree in a..
Description Responsibilities The Care Manager, Behavioral Health 2 (BCBA) is responsible for the administration and monitoring of the Autism Care Demonstration (ACD) including coordination of services for ABA Therapy, benefits provided ..
Description The Senior Quality Improvement Professional will focus organizational ... (BH)/Substance Use Disorder (SUD) clinical quality performance measures to achieve optimal ... to achieve optimal performance and quality for the..
Description The Principal Quality Leader will lead testing and ... Leader will lead testing and quality collaboration between Business and IT, ... tools and assure adherence to quality standards. Serves..
Description The Staff Utilization Management Pharmacist is a clinical pharmacist who completes medical necessity and comprehensive medication reviews for prescriptions requiring pre-authorization. The Staff Utilization Management Pharmacist work assignments involve moderately ..
Description Responsibilities The Utilization Management Nurse 2 will be responsible for performing clinical audits on medical record documentation for quality and clinical compliance with contract requirements as outlined in the Autism ..
Description Responsibilities The Care Management Support Assistant 2- ACD Referral Coordinator-will process referrals from Military Treatment Facilities (MTFs) and civilian providers for the ACD program. The ACD Referral Coordinator performs varied ..
